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For more information regarding this application, please refer to the cover letter of the Scholarship Application, the list of Scholarships Available for 2004-2005, and the Instructions for Scholarship Application, or visit the IRA Educational Foundation website at www.illinoisrestaurants.org.You may also contact the IRA Educational Foundation office at(800) 572-1086 or (312) 787-4000, x146.

This entire application must be typed and fully completed.An electronic version of this application is available online at www.illinoisrestaurants.org.A word-processed document may be used in place of this application only if presented in the exact order of this application.Handwritten applications will not be submitted for judging.

Every question must be answered.If you think a question does not apply to you, mark “N/A” in the space. If this application contains any blank spaces, other than in the sections marked "optional", it will be considered incomplete and will not be submitted for judging.

We recommend that applicants make a full copy of the completed application and all supporting documents before submitting the application package to the IRA Educational Foundation. The Foundation cannot be responsible for incomplete application packages.

Section 1 ·Personal Information

First Name Middle Initial

Last Name

Permanent Address

City County State

Zip

Phone Number

Email Address

Cell Phone

Parent/Back-up Phone Number

Social Security Number (required)

Date of Birth

Picture:Yes, I have included my picture with this application, and consent to it being used by the IRA Educational Foundation for marketing purposes

Optional information

Sex:FemaleMale

Ethnicity:

American Indian or Alaskan Nativ

Asian American or Pacific Islander

Black/African American

White/Caucasian

Hispanic

Other

Section 2 ·Application Information

A.General Application Information

Yes, I graduated / will graduate from a ProStart high school · Year

Yes, I earned / will earn a ProStart certificate · #· Year

No, I did not graduate from a ProStart high school and did not earn a ProStart certificate, but I am eligible to apply for an IRA Educational Foundation scholarship because I am pursuing a post-secondary degree in foodservice/hospitality management.

B.Have you received a scholarship from the IRA Educational Foundation before?

No Yes·Year

If Yes, Scholarship Awarded

If Yes, Career Mentor Name

Section 3 ·Interests

What are your area(s) of interest?Please circle all that apply.

Baking/Pastry

Catering

Corporate / Healthcare / School / On-site foodservice

Dietetics/Nutrition

Education

Fine dining

Food science / Research & Development

Foodservice advertising/marketing

General management

Hotel Food & Beverage

Independent restaurant management

Multi-unit concept management

Personal chef

Quick service restaurant management

Supply & distribution

Other

Section 4 ·School Information

A.Current school information

I am currently a High School student

I am currently a College student

I am not currently a student, but I intend to enroll for 2004-2005

CurrentSchool (attending during 2003-2004)

CurrentSchool's Address

City State

Zip

Cumulative GPA (out of 4.0 or ) indicate if GPA is not based on a 4.0 scale